Molecular and Genetic Medicine

Obesity and Retinopathy in Diabetes

Abstract

Snježana Kaštelan, Martina Tomi

Diabetes mellitus a chronic metabolic disorder is a fast-growing global problem with significant social, health and economic consequences. It is estimated to have affected 366 million people worldwide and is expected to nearly double by 2030 with this rising trend observed for both type 1 and type 2 diabetes. An ageing population and rising prevalence of obesity reaching almost epidemic proportions are the main reasons for this increase. Diabetic retinopathy (DR) a common and progressive microvascular complication of diabetes represents one of the leading causes of vision impairment and blindness in working-age adults in developed countries. Epidemiological and clinical studies have confirmed that the main risk factors for DR are diabetes duration, prolonged poor glycaemic control, hypertension and hyperlipidemia. In addition to the well-known risk factors increasing attention is assigned to obesity specifically due to its frequency and inter-relationship with diabetes. To date this relationship has been examined in a number of epidemiologic studies giving conflicting results with most studies confirming the positive association. Although the underlying pathophysiological mechanisms supporting the relationship between obesity and DR are yet to be defined several biological theories have been suggested comprising the potential involvement of platelet function, blood viscosity, aldose reductase activity, vaso proliferative parameters, oxidative stress and inflammation. Given that weight is changeable and can be modified by lifestyle intervention opens up implications for further research and intervention in order to elucidate the role of obesity and body weight variations on the pathogenesis of DR.